Beatles 'Help!' Ease Depression in Dementia

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Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

This randomized controlled trial conducted in patients with moderate to severe dementia living in a nursing home found that music and cooking interventions had significant beneficial effects on behavioral disorders and the related professional caregiver distress.

BOSTON -- The Beatles may bring back good memories in more ways than one: listening to the group's old familiar tunes helped to relieve depression, anxiety, and other psychological health problems among patients with moderate to severe dementia, researchers found.

Cooking and baking also improved patients' general sense of well-being, Pauline Narme, MD, of University Paris Descartes, in France, and colleagues reported here at the annual Alzheimer's Association International Conference.

"Whether randomized to group music sessions or group cooking lessons, a number of psychological measures including anxiety and depression decreased significantly in our dementia patients both during and post treatment," with a P value of <0.05, she told MedPage Today.

Based on the limited efficacy and serious side effects of pharmacological treatments used to treat psychological problems in patients with dementia, experts strongly encourage the development of nonpharmacological care strategies, Narme said.

A few small studies have suggested that musical therapy may help such patients, but few have been randomized and others have other methodological weaknesses, she said.

The new study, a randomized controlled trial accepted just this week for publication in the Journal of Alzheimer's Disease, involved 48 patients with moderate to severe Alzheimer's disease or mixed dementia living at the same nursing home.

Eleven patients were lost to attrition and the remaining 37 were randomized to either a musical or a cooking intervention group. Each intervention lasted 4 weeks, with two 1-hour sessions a week.

The vast majority of patients in both groups were female, and mean age was 87 years in the music group (18 patients) and 88 in the cooking group (19 patients).

During music sessions, popular old tunes such as Beatles hits were played, and patients were encouraged to sing or follow along by beating on a small drum.

During cooking sessions, a different recipe, such as chocolate cake or French pancakes, was collectively prepared each time.

Blind evaluations were conducted before, during, and 4 weeks after the intervention to assess short- and long-term effects.

Patients were evaluated using the Neuropsychiatric Inventory (NPI), a validated questionnaire of caregiver distress in which physicians rate how emotionally distressing they find a number of their patients' behaviors such as anxiety or depression.

The findings revealed that:

In the music group, scores on depression dropped significantly at 2 and 4 weeks (P<0.01). They then increased slightly but were still lower than at baseline 4 weeks post treatment (P<0.05).

Anxiety decreased significantly at 2 weeks (P<0.05), and then remained stable through the trial's end.

In the cooking group, anxiety and irritability dropped at 2 and 4 weeks, respectively (P<0.05 for both).

As rated by the patients, the severity of these problems also improved significantly after both interventions.

While the researchers had expected music to have a greater effect in improving mental well-being than cooking based on previous research, Narme hypothesized that the "socialization of both activities explains why both worked equally well."

William Thies, PhD, senior scientist in residence at the Alzheimer's Association, agreed. "Clinicians need to remind caregivers that people with dementia are people too. Don't just let them watch TV all day. The more you can get them to participate in family or group activities, the better," he said.

Narme had no conflicts of interest.

Thies had no conflicts of interest.

Reviewed by Zalman S. Agus, MD Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner

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